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General NPI Number Information
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NPI Number | 1144540956
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Entity Type | Organization
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Legal Business Name | NORTHRIDGE HOSPTIAL MEDICAL CENTER
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Dates
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Enumeration Date | 06/03/2010
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Last Update Date | 06/03/2010
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Provider Practice Location Address
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Address Line | 18300 ROSCOE BLVD NORTHRIDGE HOSPITAL MEDICAL CENTER
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City | NORTHRIDGE
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State | CA
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Zip | 91328
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Country | US
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Telephone | 818-885-8500
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 COLORADO AVE SUITE 538
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City | SANTA MONICA
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State | CA
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Zip | 90404-3571
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Country | US
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Telephone | 310-770-1160
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIETITIAN
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Name | ELIZABETH BERTRAND
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Credential | MS, RD
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Telephone | 818-885-8500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 852519
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License Number State | CA
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